Provider Demographics
NPI:1114562832
Name:WEBER, JORDAN DENNIS (DPT)
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:DENNIS
Last Name:WEBER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:518 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:EMMAUS
Mailing Address - State:PA
Mailing Address - Zip Code:18049-2404
Mailing Address - Country:US
Mailing Address - Phone:484-822-5350
Mailing Address - Fax:
Practice Address - Street 1:518 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:EMMAUS
Practice Address - State:PA
Practice Address - Zip Code:18049-2404
Practice Address - Country:US
Practice Address - Phone:484-822-5350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-18
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist